Curbside Consultation of the Pancreas: 49 Clinical Questions

Question 5: What Can Be Done To Minimize Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis? (continued)

Nison Badalov, MD; Scott Tenner, MD, MPH

Identification of the risk factors for post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis is essential to recognize high-risk cases in which ERCP should be avoided if possible, or in which protective endoscopic or pharmacologic interventions should be considered. If a patient has 1 or more risk factors, avoidance of ERCP should be strongly considered. Diagnostic ERCP has largely been replaced by magnetic resonance cholangiopancreatography (MRCP) and endoscopic ultrasound (EUS), which should be considered first-line in patients in whom the ERCP is merely for diagnostic…